Maximum Out of Pocket – The most you pay during a policy period (calendar year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit never includes your premium, balance-billed charges or health care your health insurance or plan doesn’t cover. Some health insurance or plans don’t count all of your co-payments, deductibles, co-insurance payments, out of network payments or other expenses toward this limit.

Co-Payment – A fixed amount you pay for a covered health care service. The amount can vary by the type of covered health care service.

Coinsurance – Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the amount we allow to be charged for services. You start paying coinsurance after you’ve paid your plan’s deductible.

Premiums versus what is paid for services

It is most important to have a low monthly premium ( I don’t plan to use my insurance often, and I am okay with paying more out of pocket costs if I have to visit the doctor).

It is most important to have low maximum out of pocket cost for the year. (I think I will visit the doctor often, and I would prefer to limit the most I will have to spend out of pocket).